DEFINING THE NEW HEALTH SYSTEM

Recent health system reforms in Aotearoa have resulted in a raft of new terms and renamed entities. For clarity, we’ve compiled a glossary of the terms midwives are most likely to come across or use in their daily mahi, and provided short explanations for each.

Te Whatu Ora | Health NZ: the overarching organisation responsible for New Zealand’s national health service, including funding and delivery of services. It will work closely with its partner, Te Aka Whai Ora | Māori Health Authority.

Te Aka Whai Ora | Māori Health Authority: an independent public health agency responsible for enhancing tino rangatiratanga, strengthening mana motuhake for hauora Māori and ensuring greater influence throughout the entire health system, to support whānau to take control of their own health and wellbeing.

Manatū Hauora | Ministry of Health: the chief steward, regulating the health system, setting its direction and policy, advising government on funding and system settings and monitoring health outcomes.

Hauora Māori Advisory Committee: advises the Minister of Health on matters relating to Te Aka Whai Ora - Māori Health Authority Board and to the Public Health Advisory Committee. The role of the committee is also to ensure that the voices of Māori are heard at all levels of decision-making in the new health system.

Kahu Taurima: a joint approach between the Māori Health Authority and Health New Zealand, which will drive the integration of maternity and early years services for a child’s first 2,000 days, from conception to five years old, across Aotearoa.

Te Pae Tata | Interim NZ Health Plan: sets out the first two years of health system transformation to improve the health and wellbeing of all New Zealanders.

Whakamaua | Māori Health Action Plan 2020-2025: implementation plan for He Korowai Oranga, New Zealand’s Māori Health Strategy, which focuses on achieving better health outcomes for Māori by setting the government’s direction for Māori health advancement over the next five years.

Pae Ora legislation: the Pae Ora (Healthy Futures) Act 2022 took effect on 1 July 2022.

Te Whatu Ora localities: geographical areas that make sense to the people who live in them. This change is a fundamental part of the new health system reform and replaces the previous DHB and PHO-focused approach. Everyone in Aotearoa will fit into a locality that reflects their community.

Te Whatu Ora districts: have replaced DHBs.

Iwi-Māori partnership boards: enable iwi, hapū and whānau to exercise rangatiratanga in their rohe. They ensure tangata whenua voices are heard and local health services reflect those who need and use them.

National Public Health Service: a new entity which will bring together the functions of the 12 former public health units, Te Hiringa Hauora - Health Promotion Agency and the Ministry of Health. It will work closely with Te Aka Whai Ora and the Ministry of Health, and the Public Health Agency to work alongside whānau, communities, and other sectors, drawing on mātauranga Māori and data to provide health promotion, prevention and protection at local, regional and national levels.

Public Health Agency: sits within Manatū Hauora (Ministry of Health); leads and strengthens population and public health, policy, strategy, regulatory, intelligence, surveillance and monitoring functions, with a greater emphasis on equity and the wider determinants of health such as income, education and housing. Plays a key role in providing advice to ministers on all public health matters.

Commissioning: the process of assessing needs, planning and prioritising, purchasing and monitoring health services, to get the best health outcomes.

Commissioning Framework: places people at the centre of commissioning, and aims to achieve equitable outcomes for everyone, wherever they live and whatever their circumstances.

National service networks: service-based networks to drive consistency in delivery of specialist and hospital services. These service networks will ensure that the quality and outcomes of care are consistent across Aotearoa, while recognising some variance can help tailor care to community needs.

Regional hospital and specialist networks: a regional network will operate as ‘one hospital’ on many sites. Those in the regional networks will ensure 24/7 hospital and specialist services are available and sustainable everywhere. They will minimise unnecessary duplication, clarify referral and discharge pathways, co-ordinate care, improve quality and reduce waste. They will also oversee collective workforce plans.

Te Korowai | The Health Charter: a document which will guide the culture, values and behaviours of the health sector. It will guide how health providers - including Te Whatu Ora and Te Aka Whai Ora - will relate to each other and together serve our whānau and communities to improve health outcomes and build towards Pae Ora. The Charter is currently in draft form and due to be consulted through the sector. square